基于数据挖掘的社区高血压患者共病现状及关联规则分析

Data mining-based analysis of comorbidity status and association rules of hypertensive patients in the community

目的了解上海社区高血压患者共病现状及各共病病种间的关联分析,为高血压患者的社区共病管理提供理论依据和数据支撑。方法收集上海某社区2018年1月—2020年12月的高血压患者诊疗和健康档案数据,分析不同性别和年龄的高血压患者多病共存现状,通过Apriori算法对共病病种、病种组合进行关联规则分析,找出高血压患者多病共存的关键疾病。结果上海社区高血压患者共病的比例为88.1%(34311/38961),远高于一般老龄人群,呈现女性高于男性、高年龄组高于低年龄组的特征,差异有统计学意义(均P<0.001)。总体病种数量分布较为分散,不同年龄组间存在差异,低年龄组以2~4种共病为主,高年龄组以4种以上为主。关联规则分析结果2种共病病种生成8条强关联规则,第1位是“高血压and慢性缺血性心脏病”;3种共病病种生成9条强关联规则,第1位是“慢性缺血性心脏病and脑血管and高血压”;4种共病病种生成的3条强关联规则中排第一的是“慢性缺血性心脏病and高脂血症and脑血管and高血压”。结论上海社区高血压患者多病共存问题不容忽视,需要有针对性地考虑共病的禁忌证、相互作用和多重用药问题。尤其是中青年的高血压共病预防尤为重要,需要做到早预警、准评估、精干预。共病病种管理在关注慢性缺血性心脏病、脑血管病、高脂血症等临床相关疾病同时,还需要关注慢性功能性肠疾患和慢性阻塞性肺病等其他系统的合并疾病。

Objective To understand the comorbidity status of hypertensive patients in Shanghai community and the correlation analysis of comorbidity,to provide theoretical basis and data support for community comorbidity management of hypertension patients.Methods The diagnosis and treatment data and health records of hypertensive patients in a community in Shanghai from January 2018 to December 2020 were collected,and the coexistence of multiple diseases among hypertensive patients of different genders and ages was analyzed.The association rule analysis of comorbidity combination was performed with Apriori algorithm to find out the key diseases of hypertensive patients with multiple diseases.Results The prevalence of comorbidity among hypertensive patients in the Shanghai community was 88.1%(34311/38961),which was much higher than that in the general elderly population.The prevalence of comorbidity in female hypertensive patients was higher than that in male hypertensive patients,and the prevalence of comorbidity in the high age group was higher than that in the low age group(both P<0.001).The distribution of the total number of diseases is scattered,and there are differences between different age groups.The low age group mainly had 2-4 comorbidities,and the high age group mainly had more than 4.The results of the association rule analysis showed that two comorbidities generated eight strong association rules,the first is"hypertension and chronic ischemic heart disease";Three comorbidities generated nine strong association rules,the first is"chronic ischemic heart disease and cerebrovascular disease and hypertension";And four comorbidities generated three strong association rules,the first is"chronic ischemic heart disease and hyperlipidemia,cerebrovascular disease and hypertension".Conclusions The coexistence of multiple diseases in Shanghai community hypertensive patients should not be ignored,and the contraindications,interactions and multiple drug use should be considered.In particular,the prevention of hypertension comorbidity in young and middle-aged people is particularly important,which requires early warning,quasi-evaluation and precise intervention.Management of comorbidities should include clinical related conditions such as chronic ischemic heart disease,cerebrovascular disease and hyperlipemia,as well as other systemic comorbidities such as chronic functional bowel disease and chronic obstructive pulmonary disease.